Help Stop Drug Diversion

By Michael L. Smith, J.D., RRT

A hospital in Miami recently discovered $14 million worth of drugs were missing from the hospital pharmacy. A hospital in Texas had drugs valued at approximately $1 million stolen during a one-year period by a ring of employees that had been stealing drugs for several years. While those cases were thefts from the pharmacy, many hospitals have large stockpiles of drugs in other departments that may not be kept securely.

Drug diversion has been an ongoing problem for hospitals for many years. Narcotics are the most common target of drug diversion. The culprit is usually a hospital employee that has become addicted or dependent on narcotics. However, the two cases above are unusual because the hospital employees involved in those cases were engaged in a criminal enterprise. In both cases, the hospital employees were stealing the hospital’s drugs for financial gain.

The Drug Enforcement Administration (DEA) regulates drugs that have a high potential for abuse and a high likelihood of causing dependence. We all know that narcotics are the drugs most frequently diverted for financial gain. For example, an Oxycontin tablet sells legally for about $6; illegally, it can command $50. A hydrocodone tablet that sells for $1.50 legally can sell illegally for $5 to $20. Obviously, there can be huge profits made by unscrupulous individuals, however we don’t always recognize that non-narcotic drugs can make a lucrative and easier target for diversion.

The drugs stolen in Miami were expensive drugs used to treat cancer patients. Unlike narcotics, these drugs were not regulated by the DEA. Since the drugs stolen in Miami were not controlled substances, they were not kept under multiple layers of security–but they were still extremely valuable. The drugs recovered from the home of one suspect had an estimated value of more than $700,000. According to one of the investigators, there is a thriving grey market for stolen drugs, including cancer drugs.

Respiratory medications, while not as expensive as some cancer medications, can still be stolen for profit. At least one case has been reported where a truckload of respiratory medications worth $1.15 million was stolen. The criminal ring involved in that theft appeared to target non-narcotic and over-the-counter drugs. The ring was involved in the theft and resale of $80 million in prescription and over-the-counter drugs. Apparently the thieves know the value of these drugs even if we don’t.

A hospital that is the subject of drug theft will suffer an economic loss but also is subject to fines and other sanctions by regulatory agencies for not having proper oversight. The Texas hospital had to pay a $20,000 fine for failing to prevent the drug theft by its employees. No hospital can afford to lose millions due to theft let alone pay a regulatory fine imposed on top of the loss.

RTs and their hospitals need to be reassessing the safety and security of their medication supplies, including non-narcotic medications.

Michael L. Smith, JD, RRT is board certified in health law by The Florida Bar and practices at The Health Law Firm in Altamonte Springs, Fla. This article is for general information only and is not a substitute for formal legal advice.

This article was originally published in Advance for Respiratory Care and Sleep Medicine.